{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:26:38Z","timestamp":1787099198046,"version":"build-2736575974"},"reference-count":5,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"7","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,8,17]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The authors present the case of a 44-year-old female with a history of intravenous drug use who previously underwent C2\u20134 anterior cervical discectomy and fusion for a retropharyngeal and ventral epidural abscess. Following a 1-year hiatus in clinical follow-up, she presented with progressive cervical myelopathy, intractable neck pain, and profound postural decompensation. Imaging confirmed severe mid-cervical kyphosis, coronal malalignment secondary to chronic osteomyelitis, and significant hardware subsidence, resulting in severe stretch myelopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A two-stage reconstructive approach was utilized to achieve spinal cord decompression, restoration of the anterior column, and correction of complex plane deformities. Stage 1 involved intraoperative traction, explantation of failed hardware, C3\u20136 corpectomies, and reconstruction with an expandable cage with screw fixation. Stage 2 involved C6\u20137 laminectomies and posterior instrumentation from C2 to T2. At the 18-month follow-up, she maintained her radiographic correction with significant neurological recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case underscores the necessity of rigorous postoperative surveillance in patients with spinal infections, particularly those with existing instrumentation, as follow-up gaps can mask insidious deformity progression. Furthermore, chronic osteomyelitis often obscures surgical landmarks through soft tissue hypertrophy and scarring. Achieving wide exposure to define reliable anatomical landmarks is paramount to safely navigating the operative field and protecting the vertebral arteries.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26453\">https:\/\/thejns.org\/doi\/10.3171\/CASE26453<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26453","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:01:19Z","timestamp":1787097679000},"source":"Crossref","is-referenced-by-count":0,"title":["Correction strategy for osteomyelitis-associated cervical deformity with illustrative 2D operative video: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5393-6845","authenticated-orcid":true,"given":"Daniel","family":"Bradach","sequence":"first","affiliation":[{"name":"St. George\u2019s University School of Medicine, True Blue, St. George\u2019s, Grenada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwase Am\u00e9e Blande","family":"Ndahayo","sequence":"additional","affiliation":[{"name":"St. George\u2019s University School of Medicine, True Blue, St. George\u2019s, Grenada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Galgano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"bib1","series-title":"Acta Orthop Belg","first-page":"807","article-title":"Spontaneous kyphotic collapse followed by autostabilisation secondary to cervical osteomyelitis in an intravenous drug abuser","volume":"73","author":"Arun","year":"2007","unstructured":"Arun RKasbekar AVMehdian SMH.Spontaneous kyphotic collapse followed by autostabilisation secondary to cervical osteomyelitis in an intravenous drug abuser. Acta Orthop Belg. 2007;73(6):807-811."},{"issue":"4","key":"bib2","series-title":"Am Fam Physician","first-page":"395","article-title":"Osteomyelitis: diagnosis and treatment","volume":"104","author":"Bury","year":"2021","unstructured":"Bury DCRogers TSDickman MM.Osteomyelitis: diagnosis and treatment. Am Fam Physician. 2021;104(4):395-402."},{"issue":"11","key":"bib3","series-title":"J Chin Med Assoc","first-page":"640","article-title":"Primary cervical osteomyelitis","volume":"76","author":"Tsai","year":"2013","unstructured":"Tsai CELee FTChang MCYu WKWang STLiu CL.Primary cervical osteomyelitis. J Chin Med Assoc. 2013;76(11):640-647. doi:10.1016\/j.jcma.2013.07.011"},{"issue":"1","key":"bib4","series-title":"Neurospine","first-page":"205","article-title":"The incidence, changes and treatments of cervical deformity after infection and inflammation","volume":"20","author":"Han","year":"2023","unstructured":"Han BWang JHai YThe incidence, changes and treatments of cervical deformity after infection and inflammation. Neurospine. 2023;20(1):205-220. doi:10.14245\/ns.2244744.372"},{"issue":"2","key":"bib5","series-title":"J Spine Surg","first-page":"363","article-title":"Combined anterior and posterior instrumented fusion for correction of severe cervical kyphotic and coronal deformity in vertebral osteomyelitis: a case report with literature review","volume":"11","author":"Bingaman","year":"2025","unstructured":"Bingaman AGupta RVKanuparthi SPKim BS.Combined anterior and posterior instrumented fusion for correction of severe cervical kyphotic and coronal deformity in vertebral osteomyelitis: a case report with literature review. J Spine Surg. 2025;11(2):363-370. doi:10.21037\/jss-24-133"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/7\/article-CASE26453.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/7\/article-CASE26453.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/7\/article-CASE26453.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:01:19Z","timestamp":1787097679000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/7\/article-CASE26453.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":5,"journal-issue":{"issue":"7"},"URL":"https:\/\/doi.org\/10.3171\/case26453","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]}}}